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Looking Ahead – The Future of NSCLC Management

Scott M. Lippman, MD - Chair
Professor and Chair
Department of Thoracic/Head and Neck Medical Oncology
The University of Texas
MD Anderson Cancer Center
Houston, Texas

Pasi A. Jänne, MD, PhD
Associate Professor of Medicine
Harvard Medical School
Associate Professor of Medicine
Dana-Farber Cancer Institute
Boston, Massachusetts

Vincent A. Miller, MD
Associate Attending Physician
Thoracic Oncology Service
Memorial Sloan-Kettering Cancer Center
New York, New York

Daniel J. Sargent, PhD
Professor of Biostatistics and Oncology
Director, Cancer Center Statistics
Mayo Clinic Cancer Center
Rochester, Minnesota

Chih-Hsin (James) Yang, MD
Professor, Graduate Institute of Clinical Medicine
National Taiwan University
Staff Physician, Department of Oncology
National Taiwan University Hospital
Taipei, Taiwan

Biren Saraiya, MD
Assistant Professor of Medicine
UMDNJ-Robert Wood Johnson Medical School
The Cancer Institute of New Jersey
New Brunswick, New Jersey

STATEMENT OF NEED
Despite the research efforts over the past several years that have enabled profound changes in the approach to NSCLC, the prognosis for the 50% of patients who present with locally advanced or metastatic disease remains poor. No single regimen has proven superior in the NSCLC population at large and usual time to progression is 4-6 months, with 30-40% of patients alive after 1 year (compared to 15% without chemotherapy), and only 10-15% are alive after 2 years. New approaches to NSCLC are critically needed to improve patient outcomes. An increased understanding of tumor biology and the development of targeted agents continues to improve these outcomes. Physicians need to know data supporting the role of such agents. A vigorous research effort has produced increased understanding of tumor biology, and the development of new agents directed at molecular targets. With these advances, the target audience may be required to change the current practice patterns.  Our analysis of the science and evidence-based treatment approaches for the management of NSCLC, specifically the examination of clinical trial endpoints and identification of appropriate treatment regimens, constitutes a need in the continuing education of oncology healthcare professionals.

TARGET AUDIENCE
This educational initiative is designed for medical oncologists, surgical oncologists, radiation oncologists, pathologists, and all other healthcare professionals managing patients with NSCLC.

LEARNING OBJECTIVES
Upon completion of this educational program, participants should be better able to:

• Discuss appropriate endpoint determinants for clinical trials evaluating therapies for NSCLC in order to enhance selection of optimum treatment for patients
• Implement EGFR mutation testing in practice to identify patients that are more or less likely to respond to agents directed at EGFR
• Given a patient case scenario, use an evidence-based approach to select first-line treatment of advanced NSCLC that results in the greatest opportunity for improved survival time while minimizing toxicity in that patient
• Given a patient case scenario, use an evidence-based approach to select treatment for recurrent and progressive NSCLC that results in the greatest opportunity for tumor response and minimal toxicity
• Discuss emerging strategies, including novel biologic and targeted agents, for the treatment of patients with recurrent and progressive disease in order to facilitate timely adoption of therapies that are proven to be beneficial in the future
  

This activity was peer-reviewed for relevance, accuracy of content, and balance of presentation by Biren Saraiya, MD.

ACCREDITATION STATEMENT
University of Medicine & Dentistry of New Jersey (UMDNJ) – Center for Continuing and Outreach Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
UMDNJ – Center for Continuing and Outreach Education designates this educational activity for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. As the content of the satellite symposium and archived webcast are identical, individuals cannot claim credit for both program formats.

METHOD OF PARTICIPATION
There are no fees for participating and receiving CME credit for this activity. During the period June 23, 2009 through June 22, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity in its entirety; 3) complete the post-test. Participants must view each section in its entirety to receive full credit for this program.

CME CREDIT
Physicians who complete the post-test with a score of 70% or better may view and print their credit letter or statement of credit via the website, www.educationalconcepts.net.

ACKNOWLEDGEMENT OF COMMERCIAL SUPPORT
This activity is supported by an educational grant from Boehringer Ingelheim.

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Please refer to the official prescribing information for each product or consult the Physicians’ Desk Reference for discussion of approved indications, contraindications, and warnings.

DISCLOSURE OF FINANCIAL RELATIONSHIPS WITH ANY COMMERCIAL INTEREST
As a sponsor accredited by the ACCME, it is the policy of ECG and UMDNJ to require that everyone who is in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest (entities producing, marketing, re-selling, or distributing healthcare goods or services consumed by, or used on, patients) and identify and resolve all conflicts of interest prior to the educational activity. The ACCME defines “relevant financial relationships” as any amount occurring within the past 12 months.

Faculty who refuse to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author of CE, and cannot have control of, or responsibility for, the development, management, presentation, or evaluation of the CE activity. For an individual with no relevant financial relationship(s), the participants must be informed that no relevant financial relationship(s) exist.

If ECG and UMDNJ determine that a potential conflict of interest exists as a result of a personal financial relationship, mechanisms will be instituted to resolve this conflict prior to the activity. ECG and UMDNJ have implemented a content validator role. That role is to ensure that the activity materials are fair-balanced, scientifically sound, and free of bias toward the commercial supporter(s) of the activity or manufacturers of products discussed in the activity.

In addition, faculty members are expected to disclose discussion of an unlabeled use of a commercial product, or an investigational use not yet approved for any purpose. ECG and UMDNJ are committed to providing learners with high-quality, unbiased, and state-of-the-art education.

I. The following faculty members have declared relevant financial relationships:

II. The CME Academic Advisor has declared relevant financial relationships:

III. The following planners and managers of ECG and UMDNJ have declared relevant financial relationships:

This activity contains information of commercial products/devices that are unlabeled for use or investigational uses of products not yet approved. Product(s) is/are not included in the labeling approved by the US FDA for the treatment of disease(s).

Educational Concepts Group, LLC (ECG) has declared the following financial relationships:
ECG receives educational grants from pharmaceutical industry and other commercial supporters. Planners, managers, and other staff members at ECG have no relevant financial relationships to disclose.